Individual provider Active NPI

James Barrett Weidner, M.D.

  • Cardiovascular Disease Physician
  • San Jose, CA
National Provider Identifier
1396892162
Registry record updated Nov 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
G60943 Issued in CA
Practice address
2030 Forest Ave Ste 110
San Jose, CA 95128-4833
Phone
(408) 294-7725
Fax
(408) 294-4442
NPI assigned
Jan 4, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 22, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X G60943 CA
Cardiovascular Disease Physician 207RC0000X G60943 CA Primary

Addresses

Primary practice location

2030 Forest Ave Ste 110
San Jose, CA 95128-4833

Mailing address

2186 Bentley Ridge Dr
San Jose, CA 95138-2421
Phone (408) 294-7725

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111229000200 CA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 0143496984 Practice locations: San Jose, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G60943CAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Santa Clara Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574380800000",
    "number": "1396892162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2186 BENTLEY RIDGE DR",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951382421",
            "telephone_number": "408-294-7725",
            "fax_number": "408-294-4442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2030 FOREST AVE STE 110",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951284833",
            "telephone_number": "408-294-7725",
            "fax_number": "408-294-4442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEIDNER",
        "first_name": "JAMES",
        "middle_name": "BARRETT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2019-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "CA",
            "license": "G60943",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "G60943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.